PDF(Pubmed)
Abstract：
As of February 18, 2020, the e-cigarette, or vaping, product use associated lung injury (EVALI) outbreak caused the hospitalization of a total of 2,807 patients and claimed 68 lives in the United States. Though investigations have reported a strong association with vitamin E acetate (VEA), evidence from reported EVALI cases is not sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC or non-THC products. This study characterized chemicals evolved when diluent oils were heated to temperatures that mimic e-cigarette, or vaping, products (EVPs) to investigate production of potentially toxic chemicals that might have caused lung injury. VEA, vitamin E, coconut, and medium chain triglyceride (MCT) oil were each diluted with ethanol and then tested for constituents and impurities using a gas chromatograph mass spectrometer (GC/MS). Undiluted oils were heated at 25°C (control), 150°C, and 250°C in an inert chamber to mimic a range of temperatures indicative of aerosolization from EVPs. Volatilized chemicals were collected using thermal desorption tubes, analyzed using a GC/MS, and identified. Presence of identified chemicals was confirmed using retention time and ion spectra matching with analytic standards. Direct analysis of oils, as received, revealed that VEA and vitamin E were the main constituents of their oils, and coconut and MCT oils were nearly identical having two main constituents: glycerol tricaprylate and 2-(decanoyloxy) propane-1,3-diyl dioctanoate. More chemicals were measured and with greater intensities when diluent oils were heated at 250°C compared to 150°C and 25°C. Vitamin E and coconut/MCT oils produced different chemical emissions. The presence of some identified chemicals is of potential health consequence because many are known respiratory irritants and acute respiratory toxins. Exposure to a mixture of hazardous chemicals may be relevant to the development or exacerbation of EVALI, especially when in concert with physical damage caused by lung deposition of aerosols produced by aerosolizing diluent oils.
摘要：
截至2020年2月18日，电子烟，或vaping，在美国，产品使用相关肺损伤（EVALI）的爆发共导致2,807名患者住院，并夺走了68条生命。尽管调查报道了与维生素E乙酸酯（VEA）的强烈关联，报告的EVALI病例的证据不足以排除其他关注化学品的贡献，包括THC或非THC产品中的化学品。这项研究的特征是，当稀释油被加热到模拟电子烟的温度时，化学物质会产生。或vaping，用于调查可能导致肺损伤的潜在有毒化学物质的生产。VEA,维生素E,椰子,和中链甘油三酯(MCT)油各自用乙醇稀释,然后使用气相色谱质谱仪(GC/MS)测试成分和杂质。将未稀释的油在25°C下加热(对照),150°C,和在惰性室中的250°C以模拟指示来自EVP的雾化的温度范围。使用热脱附管收集挥发的化学物质，使用GC/MS分析，并确定。使用保留时间和与分析标准相匹配的离子光谱来确认所鉴定的化学物质的存在。油的直接分析，收到的,发现VEA和维生素E是其油脂的主要成分，椰子油和MCT油几乎相同，具有两个主要成分：甘油三辛酸酯和2-（癸酰氧基）丙烷-1,3-二辛酸二酯。与150°C和25°C相比，当稀释油在250°C加热时，测量到更多的化学物质，并且强度更大。维生素E和椰子油/MCT油产生不同的化学排放。一些确定的化学物质的存在具有潜在的健康后果,因为许多是已知的呼吸刺激物和急性呼吸毒素。暴露于危险化学品的混合物可能与EVALI的发展或恶化有关，特别是与雾化稀释油产生的气溶胶的肺部沉积引起的物理损伤相一致时。
